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It used to refer to people who were really fat. I mean, really fat. Pathologically gross, poor devils. These days it means anybody carrying a bit more than a consensus of doctors has defined as healthy.

This would be fine if physicians today confined themselves to their science, which is advice on bodily health, but not all of them do. A messianic few are more excited by the body politic than any body in particular.

Not for them the busy, messy, confusing business of dealing with sick or worried, usually inarticulate, individuals with inconsistent symptoms. They prefer to diagnose society, which they can do from a desk in universities where they deal with statistics that can be made to fit consistent, socially responsible conclusions.

If you wonder why social research never produces unexpected results like real science, so do I. Be that as it may, the researchers share their findings in academic journals and convinced of its importance they march fearlessly out of their faculty into the public domain.

There, something strange happens. They are lionised by the media. Public health campaigns make compelling news because they challenge things we really like, such as sugar, junk food, alcohol. We already knew these were naughty but, goodness, look at the damage on a social scale. The press and public eat up these research findings but, oddly, governments generally don't.

Or at least, governments often don't act on it in the way the public health campaign prescribes. They may give the campaign more finance for public "education" against excessive consumption of the stuff but governments are strangely reluctant to bring their powers of regulation and taxation to bear, especially taxation.

This is strange because there is seldom much genuine public debate about the evils of the sweet, fatty or intoxicating treats in question.

Manufacturers and distributors of them may attempt to question the case against them, or at least the solutions proposed, but their arguments are easily dismissed as vested interest. In fact the more the industry tries to engage in a debate, the more it reinforces the suspicion - strenuously promoted by public health campaigns - that the Government has sold out to the industry's insidious efforts behind the scenes, probably for election donations. Why else, the campaigners ask, would rational people fail to do everything in their power to improve public health?

Well, I can think of a reason but I'm running a risk in advancing it, because health campaigners are so convinced of the righteousness of their cause they can only conclude that anybody who questions it also has a vested interest. I'm constantly surprised how quickly these people, who must be good-natured, public-spirited, socially responsible and intellectually stimulated, play the man, not the ball.

The first thing they do when challenged is to call into question the challenger's motive. If the person works for a think tank that is privately funded it will almost certainly have the relevant industry among its sponsors. Expose that and health professions see no need to address the argument. Their own reliance on grants awarded for research that tends to reinforce an institutional view is, in their view, not the same thing.

My only material interest in this subject is the same as that of everyone in an industry supported by advertising, and that does not stop media giving public health campaigns exhaustive publicity, so I think I may be safe.

The reason governments don't regulate and tax these vices to near extinction, I'd suggest, is that while health is important, it's not all important. Other things are important too, such as the integrity of the tax system. Health professionals may be aghast at that suggestion but tax principles are socially important.

We have a simple, fairly comprehensive tax on consumption that should not be made more variable, complicated and compromised without very good reason. Discouraging sales of fizzy drink or hamburgers is not, to my mind, sufficient reason.

The "obesity epidemic" is not convincing but even if it was, the case for health taxes would not overwhelm all other considerations, like choice, pleasure, personal and parental responsibility and the right of adults to take risks if they wish.

Doctors who deal with individuals understand this. General practitioners have been obliged to apply the findings of obesity research and most of us have probably been told we are above the weight the research says we should be. We might have welcomed this advice as a spur to diet, or ignored it. Doctors know real people have balanced lives with priorities besides health.

Doctors attending to the public health need to realise that too. We listen to them, but when they use terms such as obesity most people take their wisdom with a healthy grain of salt.